Overview
Malawi’s BRIDGE II is the next generation of prevention programming designed to scale up and deepen HIV/AIDS prevention activities in Malawi by removing barriers to individual action and confronting drivers of behavior at the normative/society level.
The BRIDGE II Project is a five-year USAID funded HIV prevention program aimed at promoting normative behavior change and increasing HIV preventive behavior among the adult population in Malawi. The program is implemented by Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) in partnership with Save the Children Federation (SC), Pact Malawi and The International HIV/AIDS Alliance (Alliance). Local partners include Corporate Graphics, Youth Net and Counseling (YONECO), Galaxy Media Consultants, Story Workshop, and National People Living with HIV/AIDS in Malawi (NAPHAM).
The overall program objective is to contribute towards the reduction of new HIV infections among the adult population in Malawi. By 2014, we envision BRIDGE II will achieve the following outcomes:
- Men and women will have personalized understandings of their HIV risk, and believe they have the skills, knowledge, and motivation necessary to prevent infection.
- Supported by normative change, proactive services, and dynamic institutions, individuals are using available HIV services and adopting safer sexual behaviors, particularly those related to a key driver of the epidemic, Multiple Concurrent Partnership (MCP). Their behavior change is deep and lasting, and an inspiration to others.
- Norms are redefined to recognize, value, and reward couple communication about prevention and sero-status, compassion for those with HIV and AIDS, protection of self and others, gender equity, and rejection of cross-generational sex, alcohol/substance abuse, and harmful traditional practices.
- HIV and other health care providers never miss an opportunity to provide both HIV negative and positive clients with proactive information, counseling, and referral. They will do this through traditional venues, such as client visits, and new approaches, such phone hotlines, cell phone technology, and community events.
- Malawian institutions are taking the lead in HIV prevention in an atmosphere of coordination and collaboration, with a vibrant exchange of ideas, information, and best practices.
BRIDGE II is a strategic, evidence-based communication program that builds on the Nditha! [4] (“I can”) brand developed under BRIDGE I [5], a USAID funded HIV Prevention project that was led by CCP from 2001-2008. Through the combination of proven community methodologies, interpersonal communication and innovative approaches, BRIDGE II is scaling-up BRIDGE I’s [5] successes while confronting specific drivers of HIV such as multiple concurrent partnerships (MCPs), alcohol/substance abuse, women’s vulnerability, and male norms, and promoting collective efficacy and normative change. In addition, BRIDGE II is linking prevention and referral systems with other HIV/AIDS-related services through existing networks while using m-health to increase access while strengthening forums for exchange of ideas, research, and strategy harmonization, and building capacity of local institutions to lead a coordinated and sustained HIV prevention effort.
Accomplishments
- Malawi’s Tasankha! [6] (Our Choice!) campaign is a multi-media effort under the BRIDGE II Project. The Tasankha! [6] campaign promotes family values and positive behavioral choices in addressing multiple concurrent partnerships as a key driver of new HIV infections in Malawi.
- Chenicheni Ntchiti? (What is the reality?) Radio Program started airing on MBC Radio 1 and is BRIDGE IIs’ flagship radio program that moves people beyond abstract understanding of HIV risk to personalized understanding.
- The Radio Diary Program is an innovative and practical way of addressing the issues of marginalization many people living with HIV and AIDS face. The Radio Diary Program helps people to deal with the low perception of the severity of HIV and AIDS and overcome some of the stigma that prevents them from getting an HIV test, or discussing HIV prevention with their partners.
- BRIDGE II is scaling up the use of transformative tools developed during BRIDGE I [6] project, including The Hope Kit [6] and Planting our Tree of Hope [6] toolkits. The Hope Kit [6] is a package of interactive and participatory tools designed to guide individuals and community groups to develop personal and appropriate HIV prevention strategies. The Planting our Tree of Hope [6] toolkit is a set of practical, experiential learning activities designed to help people living with HIV and AIDS and their partners and families address a range of HIV and AIDS related issues through the use of personal stories of men, women and couples who have overcome barriers and are living positively.
- BRIDGE II supports six workplace programs in order to strengthen behavior change interventions where HIV workplace programs are already in existence and advocate with those that have not yet established HIV workplace programs or whose commitment is low to implement them.
- Working to extend HIV prevention activities to PLHIV, BRIDGE II is accessing a broad network of support groups. Activities include: training of community members on how to facilitate small group discussions using the Hope Kit [6] and Planting our Tree of Hope [6], training community members on how to facilitate discussion in a radio listening group, and training PLHIVs in interactive drama.
- BRIDGE II is facilitating the Community Interactive Drama Program with the aim of strengthening the capacity of community-based theatre groups.
- BRIDGE II is implementing a pilot referral system to improve uptake and health seeking behaviors, as well as ensure a coordinated approach in service delivery of HIV prevention services.
- Utilizing Pact’s Organizational Network Analysis (ONA) methodology BRIDGE II examined the patterns of interaction among network members within BRIDGE II districts in order to inform discussions and capacity building strategies.
- A baseline survey was conducted by the BRIDGE II Project. 1,812 (889 males; 923 females) respondents from the 11 BRIDGE districts were interviewed, 15 focus group discussions were conducted, and 12 Key Informants were interviewed. The aim of the research was to collect both qualitative and quantitative data in order to better understand the drivers of HIV in Malawi and how to inspire community action to prevent further transmission.
